XY5-13830-11601
2 vaccinations
2 coded responses
16 check-ins
2 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 761 / TX
- Registered
- 2021-01-12
- Relationship
- Self
- Race
- N/A
- Ethnicity
- N/A
Timeline
-
2021-01-12
Registered in v-safe
-
2021-01-12
Dose 1 — Moderna
-
2021-01-13
Survey response — days 1–6 daily, dose 1MedDRA: Unevaluable event — Feeling: Good · Site: Redness · Rash, not including the immediate area around the injection siteMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-01-16
- 2021-01-18
- 2021-01-19
- 2021-01-26
- 2021-02-02
- 2021-02-11
-
2021-02-12
Dose 2 — Moderna
- 2021-02-25
- 2021-02-26
- 2021-03-05
-
2021-03-13
Survey response — 28 day, dose 2MedDRA: Rash — Feeling: GoodMedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
- 2021-03-20
- 2021-03-28
- 2021-05-14
- 2021-08-13
- 2022-02-12
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-12 | Moderna | |
| 2 | 2021-02-12 | Moderna |
Free text
Release 1
Systemic reaction (other): I am very concerned that the vaccine used might not have been effective. She was giving about 4 shots an hour and when I was called there were about 20 syringes already filled laying on her desk. I asked her where the bottle of cVaccine was and she said she fill up a bunch at a time. I did not see a vaccine vial. I told her I was concerned about the vaccine not being kept cold and I touched the syringe and the vaccine wasn't cold. She told me it had to be room temperature to give it. I am angry at myself fir not having her get me a fresh shot. I do not have confidence that I was properly vaccinated and I don't know who to talk to. Please text or call me about this. (b)(6)
redacted (b)(6)
Release 5
Symptoms: Mr forehead broke out with a painful rash after my last shot and may be getting worse not better. I have not had that problem in the past so Im not sure if it could be related to the shot. Havent had any other changes to cause it to break out.
Free-text releases are not linked to a specific survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Rash | ✓ | ✓ | ✓ |
| SRO | Unevaluable event | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release